Morbidity and mortality

MISSING IMAGE

Material Information

Title:
Morbidity and mortality
Uniform Title:
Morbidity and mortality (Washington, D.C. : 1952)
Running title:
Weekly mortality report
Weekly morbidity report
Morbidity and mortality weekly report
Abbreviated Title:
Morb. mortal.
Physical Description:
25 v. : ; 27 cm.
Language:
English
Creator:
United States -- National Office of Vital Statistics
Communicable Disease Center (U.S.)
National Communicable Disease Center (U.S.)
Center for Disease Control
Publisher:
The Office
Place of Publication:
Washington, D.C
Publication Date:
Frequency:
weekly
regular

Subjects

Subjects / Keywords:
Communicable diseases -- Statistics -- Periodicals -- United States   ( lcsh )
Mortality -- Periodicals -- United States   ( lcsh )
Morbidity -- Periodicals -- United States   ( mesh )
Mortality -- Periodicals -- United States   ( mesh )
Statistics, Medical -- Periodicals -- United States   ( lcsh )
Statistics, Vital -- Periodicals -- United States   ( lcsh )
Genre:
federal government publication   ( marcgt )
statistics   ( marcgt )
periodical   ( marcgt )

Notes

Additional Physical Form:
Also issued online.
Statement of Responsibility:
Federal Security Agency, Public Health Service, National Office of Vital Statistics.
Dates or Sequential Designation:
Vol. 1, no. 1 (Jan. 11, 1952)-v. 25, no. 9 (Mar. 6, 1976).
Issuing Body:
Issued by: U.S. National Office of Vital Statistics, 1952-Jan. 6, 1961; Communicable Disease Center, 1961- ; National Communicable Disease Center, ; Center for Disease Control, -Mar. 6, 1976.
General Note:
Title from caption.

Record Information

Source Institution:
University of Florida
Rights Management:
All applicable rights reserved by the source institution and holding location.
Resource Identifier:
oclc - 02246644
lccn - 74648956
issn - 0091-0031
ocm02246644
Classification:
lcc - RA407.3 .A37
ddc - 312/.3/0973
nlm - W2 A N25M
System ID:
AA00010654:00189

Related Items

Preceded by:
Weekly mortality index
Preceded by:
Weekly morbidity report
Succeeded by:
Morbidity and mortality weekly report

Full Text
ONAL COMMUNICABLE DISEASE CENTER
NATIONAL COMMUNICABLE DISEASE CENTER


Vol. 17, No. 24


WEEKLY

REPORT

Week Ending
June 15, 1968


EDUCATION, AND WELFARE PUBLIC HEALTH SERVICE

SERVICES AND MENTAL HEALTH ADMINISTRATION


CONTENTS


Between Jan Y?.'ind April 307 cases of
measles were report y State Depart-
ment of Health (NJSDH) 1iis represents an 11
percent increase over the 277 cases reported during the
first 4 months of 1967. Essex, Passaic, and Bergen Coun-
ties, which represent approximately 35 percent of the
New Jersey 1960 population, accounted for 68 percent of
the cases reported in 1968.
Since January 1, 1968, the New Jersey Division of
Preventable Diseases has maintained a surveillance pro-
gram by which all cases of measles rieorted to the
NJSDH are investigated in an attempt to verify the diag-


Current Trends
Measles-New Jersey ....... . 221
Epidemiologic Notes and Reports
Gastroenteritis Portland, Oregon. . .... 222
International Notes
Follow-Up Obscure Disease Related to African Monkeys. 223
Influenza- South America .................... 228

nosis, define the source of transmission, and determine
the relationship, if any, of the cases to measles immuni-
zation. In the first 4 months of this year, approximately
90 percent of the cases reported to the NJSDH were in-
vestigated; 38 percent of the cases investigated were
found not to be measles (Table 1). If the family of a case
(Continued on page 2Z2)


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
24th WEEK ENDED MEDIAN CUMULATIVE, FIRST 24 WEEKS
DISEASE MEDIAN
SJUNE 15, JUNE 17, 1963 1967 MEDIAN
1968 1967 1968 1967 1963 1967
Aseptic meningitis ....................... 67 45 39 754 791 676
Brucellosis ............................ 4 6 6 71 117 117
Diphtheria .............................. 1 2 86 50 79
Encephalitis, primary:
Arthropod-borne & unspecified ........... 19 27 394 600 ---
Encephalitis, post-infectious ............. 8 21 --- 255 417 -- -
Hepatitis, serum ........................ 90 43 6 6 1,852 920 19,374
Hepatitis, infectious ................... 789 740 66 20,170 18,454
Malaria .......................... 42 41 2 970 911 43
Measles rubeolaa) ......... ............ 651 1,244 6,268 16.617 53.043 220,468
Meningococcal infections, total ........... 45 35 48 1,552 1,346 1.505
Civilian .................... ......... 40 34 1,401 1,248 -
Military ............................... 5 1 --- 151 98
Mumps ................................. 2,943 -- 111,940
Poliomyelitis, total ....... .. ............ ..1 1 19 10 18
Paralytic ............................. 1 1 19 9 16
Rubella (German measles) ............... 1.624 1.827 --- 37,659 34,740 -- -
Streptococcal sore throat & scarlet fever.... 6,294 6,350 6,350 246,028 265,882 240,727
Tetanus ............................... 3 8 58 58 81 98
Tularemia .............................. 4 3 8 81 68 102
Typhoid fever .......................... 11 4 6 127 177 162
Typhus, tick-borne (Rky. Mt. spotted fever) 8 10 10 62 67 49
Rabies in animals ....................... 45 197 194 1,725 2,151 2,151

TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ........................................... 2 Rabies in man: .................................... -
Botulism: ...................................... .... 1 Rubella, Congenital Syndrome: ......................... 3
Leptospirosis: ....................................... 13 Trichinosis: Calif. -1, N. J. 1, NY Upstate 4, Tex. 1.. 35
Plague: ...................................... .... Typhus, marine: .................................... 6
Psittacosis: Calif. -1 .............................. 19 Polio, Unsp,: ............................






Morbidity and Mortality Weekly Report


MEASLES (Conttiued from page 222)


could not be reached and the case was not investigated,
the case was assumed to be measles and was reported as
measles to NCDC.
The major portion of these reported cases (73 per-
cent) occurred in nine New Jersey municipalities (Table
2). Measles immunization programs are being planned or
have recently been held in each of these municipalities.
In Newark, cases have continued to appear despite
the program on March 3, 1968, in which 6,802 children
were immunized. Because of the continued occurrence of
cases, weekly immunization programs are now being
conducted in neighborhood houses used as clinic sites.
In Paterson, since May 16, 1968, weekly (Thursday morn-
ing) immunization programs have been held in the health
department clinics.
Table 1
Investigation of Cases

Number Numbern Number Percent of Number Percent of
Month Case ( Cas(es Cases Cases lnes Case Cases Reported
(1968) Reported Invesi- Found tigated Found Reporied to NJSDH hlch
to NJSDH*I gatrd not to he not to Ibe o SCDC(' were reported
Measles -iealeI to tIh NSCDC
January 51 4H 16 37.5 3s 64 7
FebruarS 86 0 3 30) 36 1 156 65 1
March 149 139 52 37 4 97 65 .1
\prl 176 141 55 39.3 121 6Bh
Total 146 410 155 37 h 3)07 66.5

"Now se a mo wslh 0>., o ser- nshv O o e-net *n h0,.I


Table 2
Nine Municipalities with Measles Outbreaks, New Jersey,

January April, 1968

Nu mir of Cases by Month Immunizatlon
Munlcipaity (Counts %I... r u I, Program in
Ah-rron Atlanltc 20 May 1968
Bo"ia Bergimn 2 19 May 1968
Huikensack Bergten 2 6 June 196H
Eas. Orange E, ex 4 10 5 May 196H
Niwairk Es-ex 9 13 as 25S Mar-h 196B
Orange E "x 2 6 12 June 1968
Nrw Brunsw- ik Middlelise 5 2 January 1960
Pr.t rson Pia i IWt 4 19 14 May 1i968
Vornon Susox 11 May 168
0. ul3l, n P-.-L-) I M-rihi4xu n. .lth Derr-u.Con h Chnl

As a result of the recent increase in immunization
programs, personnel have been unable to maintain the
previous level of measles surveillance. For example, in
May i itriilh May 17) only 63 percent of the cases re-
ported to the NJSDH were investigated, as contrasted
with approximately 95 percent investigated during each of
of the first 3 months of 1968 (Table 1). This may explain
the 10 percent increase in the number of cases reported
from New Jersey to NCDC in May.
(Reported by Ronald Altman, M.D., State Epidemiologist,
New Jersey State Department of Health; and two EIS
Officers.)


EPIDEMIOLOGIC NOTES AND REPORTS
GASTROENTERITIS Portland, Oregon


An outbreak of gastroenteritis which occurred in Port-
land, Oregon, between May 17 and 20, 1968, has been traced
to a meal served at a local restaurant on May 17. A total
of 450 persons, including 75 who were attending two ban-
quets and 375 individual diners, were served at the restau-
rant that evening. Interviews were obtained from 83 persons;
73 had been at the banquets and 10 had been individual
diners. Of the 73 persons attending the banquet, 62 (85
percent) reported illnesses, and of the 10 individual diners,
eight (80 percent) reported illnesses, giving an overall
attack rate of 84 percent. Onsets of illness ranged from
3 to 67 hours after the meal with a mean incubation period
of 36 hours. Symptoms of the ill persons included fever
(54 p-r ..-rii i. myalgia (37 -r. --rnii abdominal cramps (64
percent), nausea (71 percent), vomiting (46 percent), and
diarrhea (63 percent). The durations of illness ranged from
8 to 96 hours with a mean duration of 30 hours. No persons
were hospitalized and no deaths occurred.
Food items consumed by the diners included shrimp
cocktail,oyster cocktail, king crab, steak, broiled lobster,
green beans, baked potato and whipped margarine, salad,
sherbet, ice water, and coffee. None of the foods could be
implicated as the responsible vehicle by food histories.
Stool cultures were obtained 1 week after the meal
from 11 ill persons, three well persons, and four asympto-
matic food handlers. All cultures were negatii, for salmo-


nella and shigella, but five ill persons and two food hand-
lers had cultures positive for enteropathogenic Escherichia
coli (EEC) 0124:B17. Follow-up cultures obtained 2 weeks
after the meal revealed that only two food handlers were
still positive for EEC. In .l.Ii'un,. cultures from one other
ill person and one other food handler were positive for
Clostridium perfringens, type A. Inspection of the restau-
rant showed poor hygienic conditions in the restaurant
kitchen, the presence of numerous II..-. and improper food
preparation techniques. Samples of all food items, as well
as scrapings of food from the cutting boards were cultured
and were negative for salmonella and shigella, but several
other organisms were cultured from different foods includ-
ing EEC 0124:B17 from lobster, Cl. perfringens, type A
from whipped margarine, and low concentrations of Staph-
ylococcus aureus from the sherbet. Samples of the water
supply as well as dye studies revealed no bacterial con-
tamination of the water.
Subsequent in, -liiiiii'n disclosed that similar ill-
nesses had occurred among persons who had eaten at the
restaurant on May 16. Food histories were obtained from
73 persons, 35 of whom (48 percent) had been ill. Symp-
toms and incubation periods were similar to those of the
persons who became ill after the May 17 meal. No ill-
nesses have been reported from persons Ieaming at the
restaurant after May 17.


222


June 15, 1968






Morbidity and Mortality Weekly Report


Local health officials suggested numerous improve-
ments in food handling techniques, and a follow-up inspec-
tion of the restaurant revealed great improvements in over-
all sanitation and techniques of food preparation.
(Reported by Vivian E. Runte, Nurse Epidemiologist, and
M. A. Holmes, D.V.M., Public Health Veterinarian, Port-
land City Health Department; John H. Donnelly, M.D.,
Health ''..', and Robert Peth, Sanitarian, Multnomah
County Health Department; James H. Stewart, M.D., Health
Officer, and Eldred A. Henderson, Sanitarian, Washington
County Health Department; and an EIS Officer.)

Editorial Note

The symptoms, long incubation period,' and short
durations of illness are suggestive of EEC as the causa-
tive agent in this outbreak. Whether EEC can cause gas-
troenteritis in adults has been a point of controversy. How-
ever several recent outbreaks have pointed to an associa-
tion between EEC and gastroenteritis in adults1'2'3'4
(MMWR, Vol. 16, No. 30). That EEC was the responsible
agent in this outbreak is impossible to prove. The fact
that the organism was isolated from five ill persons and
two food handlers as well as one of the food items does


suggest a possible causal relationship. All previous re-
ported outbreaks of diarrhea in adults associated with
with EEC have been waterborne; in this outbreak,
no food items were implicated by food histories although
EEC 0124:B17 was recovered from lobster. Only a minority
of those who became ill had eaten lobster, and it would
appear that the outbreak was not caused by one particular
food item. Although contaminated water is certainly a
possibility, it seems unlikely that the exact route of
contamination can be identified.
References:
'Schroeder, S.A., Caldwell, J.R., Vernon, T.M., White, P.C.,
Granger, S.I., and Bennett, J.V.: A waterborne outbreak of
gastroenteritis in adults associated with enteropathogenic
E. coli 0111:84. Lancet 1:737-739, 1968

2Costin, I.D., Voiculescu, D., and Gorcea, V.: An outbreak
of food poisoning in adults associated with Escherichia coli
serotype 86:B7:H34. Path Microbiol 27:68-78, 1964.

3Lanyi, B., Szita, J., Ringelhann, B., and Kovach, K.: A water-
borne outbreak of enteritis associated with Escherichia coli
serotype 124:72:32. Acta Microbiol Acad Sci Hung 6:77-84,1959.
Bengtsson, S., Berg, R., Danielsson, D., Landmark, K.M.,
Norbring, F., and Sandler, O.: A waterborne epidemic of enter-
opathogenic E. coli. Translated from Sartryck ur LaKartid-
ningen 63:4599, 1966.


INTERNATIONAL NOTES
FOLLOW-UP OBSCURE DISEASE RELATED
TO AFRICAN MONKEYS


In the fall of 1967, NCDC was first informed of a dis-
ease of unknown etiology in persons having contact with
African green monkeys (Cercopithecus aethiops) (MMWR,
Vol. 16,Nos. 36 and 37). The clinical disease was charac-
terized by severe prostration, myalgia, nausea, vomiting,
and diarrhea. Conjunctivitis occurred early in the disease
followed by enanthem and exanthem of scarlatiniform in
appearance. Leukopenia developed initially followed by
leukocytosis. Thrombocytopenia with a resulting bleeding
tendency from mucous membranes was reported. Later
stages of the disease showed evidence of liver, heart, and
brain involvement. Deaths occurred from 7 to 12days after
onset.
A total of 30 cases with 7 deaths were reported occur-
ring most frequently in persons who had contact with mon-
key tissues or cell cultures, particularly kidney tissue
cell cultures. No cases were attributable to contact with
intact animals only. Early intensive laboratory investi-
gation with sera and tissue from affected human cases
revealed an agent(the Marburg-Frankfurt agent) that infects
and kills guinea pigs with resulting splenomegaly and
degeneration of the liver (MMWR, Vol. 16, Nos. 38, 42,
and 43). Although rickettsia were not found, hepatic cells
from guinea pigs showed large numbers of intracytoplasmic
granules (500-600 p) resembling rickettsia. Convalescent
sera from febrile guinea pigs and patients were negative
against rickettsialpox, typhus, and Rocky Mountain spotted
fever antigens. Subsequent characterization of the agent
including growth in tissue cultures, RNA content, and


electron micrographic appearance has suggested that the
agent is a virus.
Recently serologic studies on 129 African green mon-
keys were conducted at the Special Studies Laboratory,
NCDC. The monkeys' sera were tested by complement
fixation (CF) tests for antibody to the African green mon-
key virus. Of the 129 sera tested, 65 (50 percent) had pos-
itive reactions with titers ranging from 1:8 to_> 1:256. The
rate of positive reactions did not differ significantly be-
tween sera obtained from imported animals in the United
States and from animals soon after capture in Africa. The
monkeys originated in Ethiopia, Kenya, and Uganda, and
positive reactors were found among animals from each
country.
Sera from a limited number of captured chimpanzees,
gorillas, and orangutans were also tested and approximately
the same percentage of animals demonstrated CF anti-
body as that observed for the 129 African green monkeys.
In tests conducted to date, sera from bushbabies and wild
rodents collected in Africa and sera from 17 U.S. laboratory
workers who have had contact with green monkeys for
several years have shown no antibody to the virus.
Although no known antibody cross-reactions to the
Marburg-Frankfurt virus occur with any other virus, virus
neutralization tests must be performed before these sero-
logic results can be confirmed and adequately interpreted.

(Reported by Special Studies Laboratory, Virology Section,
Laboratory Program, NCDC.)


June 15, 1968







22-1 Mrrlhmliyi and Mortality Weekly Report


TABI.E III. (ASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JUNE 15, 1968 AND JUNE 17, 1967 (24th WEEK)


ENCEPHALITIS HEPATITIS
ASEPTIC Hu SISDI IA 1 Primary Post-
AREA MENINGITIS includingious Serum Infectious MALARIA
Infectious Serum Infectious
unsp. cases




NEW ENGLAND.......... 6 19 34
Maine.*............. 3
New Hampshire* ... -
Vermont ............
Massachusetts...... 1 11 13
Rhode Island....... 2 -
Connecticut........ 6 6 18

MIDDLE ATLANTIC...... 4 8 4 2 19 134 144 9
New York City...... 2 2 3 15 53 71
New York, up-State. 2 2 20 25
New Jersey......... 2 1 2 33 18 4
Pennsylvania....... 4 2 28 30 5

EAST NORTH CENTRAL... 11 7 5 8 1 114 94 4
Ohio................ 8 7 21 22
Indiana............. 1 2 11 7 -
Illinois........... 2 2 4 33 30 2
Michigan ........... 3 1 1 1 41 30 2
Wisconsin.......... I 8 5

WEST NORTH CENTRAL... 2 1 2 1 1 2 51 31 4
Minnesota.......... 1 1 2 9 4
Iowa............... 1 6 1
Missouri............ 1 11 21 23
North Dakota ....... 2 -
South Dakota....... -
Nebraska ........... 3 1
Kansas.............. 1 10 2 4

SOUTH ATLANTIC....... 5 6 1 1 5 73 85 13
Delaware............. 1 2 5
Maryland........... I 3 13 26 1
Dist. of Columbia.. -
Virginia........... 12 15 2
West Virginia...... 1 2 3 3
North Carolina..... 6 5 6
South Carolina....* 1 2 1
Georgia............ 1 22 8 2
Florida............ 3 3 1 1 13 23 1

EAST SOUTH CENTRAL... 2 1 1 42 50
Kentucky ........... 2 5 25
Tennessee .......... 1 21 12
Alabama............ 4 3
Mississippi........ 12 10

WEST SOUTH CENTRAL... 23 5 3 5 1 66 58
Arkansas ........... 3
Louisiana.......... 19 4 3 2 1 20 11
Oklahoma.............. I 10 2
Texas ............ 3 1 3 36 42

MOUNTAIN............. 1 1 1 1 34 73 4
Montana. ........... 8 2
Idaho.............. 2 1
Wyoming ............. 1 2
Colorado........... 1 1 14 4 2
New Mexico......... I 2 48 2
Arizona.............. 6 7
Utah............... 1 9
Nevada....... ........

PACIFIC.............. 19 17 1 5 9 5 55 256 171 8
Washington......... 1 1 2 1 37 14 2
Oregon.............. 3 16 15
California......... 17 9 1 4 7 3 51 203 141 6
Alaska..... ...... -
Hawaii............. 2 8 1 -- 1

Puerto Rico ........ .. 21 21

*Delayed reports: Diphtheria: Tex. 16
Encephalitis, primary: N.H. 1
Hepatitis, Infectious: Me. 3







Morbidity and Mortality Weekly Report 225


TABLE 111. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JUNE 15, 1968 AND JUNE 17, 1967 (24th WEEK) CONTINUED


MEASLES (Rubeola) MENINGOCOCCAL INFECTIONS, MUMPS POLIOMYELITIS RUBELLA
TOTAL
AREA Total Paralytic
AREA Cumulative Cumulative Total Paralytic
Cum.
1968 1968 1967 1968 1968 1967 1968 1968 1968 1968 1968
UNITED STATES... 651 16,617 53,043 45 1,552 1,346 2,943 1 1 19 1,624

NEW ENGLAND.......... 77 954 719 2 80 57 348 473
Mainet............. 30 214 6 3 9 11
New Hampshire*..... 113 72 7 2 4 -
Vermont ............ 1 28 1 17 9
Massachusetts*..... 24 307 269 35 29 177 140
Rhode Island....... 1 60 7 4 36 100
Connecticut........ 53 502 76 2 24 19 105 213

MIDDLE ATLANTIC...... 179 2,916 1,954 15 268 205 184 263
New York City...... 121 1,258 359 5 55 35 120 144
New York, Up-State. 28 1,033 425 1 43 50 NN 47
New Jersey......... 27 490 457 6 96 78 64 70
Pennsylvania....... 3 135 713 3 74 42 NN 2

EAST NORTH CENTRAL... 106 3,374 4,690 5 175 168 871 287
Ohio................ 3 261 1,042 45 62 27 50
Indiana............. 24 592 538 2 23 21 51 11
Illinois........... 33 1,264 817 39 40 136 51
Michigan........... 11 217 833 2 52 34 343 66
Wisconsin.......... 35 1,040 1,460 1 16 11 314 109

WEST NORTH CENTRAL... 7 332 2,658 1 78 62 183 53
Minnesota........... 2 15 122 18 15 35 2
Iowa................ 81 723 5 12 135 38
Missouri........... 3 76 298 26 12 13 12
North Dakota....... 2 113 780 3 -
South Dakota....... 4 47 4 6 NN -
Nebraska........... 35 596 6 11 1
Kansas............. 8 92 1 16 6

SOUTH ATLANTIC....... 55 1,211 6,214 6 323 258 191 88
Delaware............ 12 37 5 5 13 6
Maryland............ 1 73 119 1 22 31 35 16
Dist. of Columbia.. 6 20 1 12 9 6 3
Virginia........... 23 260 1,890 23 27 30 20
West Virginia...... 25 208 1,280 8 19 42 40
North Carolina..... 1 265 825 3 65 50 NN -
South Carolina..... 12 478 54 24 5 -
Georgia............. 1 4 29 1 59 43 -
Florida............. 4 371 1,536 75 50 60 3

EAST SOUTH CENTRAL... 12 495 4,767 4 134 116 137 38
Kentucky............ 1 164 1,194 2 51 33 16 11
Tennessee.......... 54 1,649 2 46 47 104 23
Alabama............ 69 1,280 18 24 14 4
Mississippi......... 11 208 644 19 12 3 -

WEST SOUTH CENTRAL... 85 4,247 16,434 5 263 194 254 1 1 11 118
Arkansas........... 2 1,399 15 24 -
Louisiana.......... 2 143 3 71 77 2 5
Oklahoma........... 4 109 3,306 48 13 1 -
Texas.............. 81 4,134 11,586 2 129 80 251 1 1 11 113

MOUNTAIN............. 44 869 4,051 24 25 160 56
Montana............ 66 262 2 6 -- 1
Idaho............. 1 16 356 10 1 4 2
Wyoming.............. 49 68 -
Colorado............. 20 436 1,338 7 10 41 21
New Mexico......... 3 80 541 3 14 3
Arizona.............. 18 196 900 1 4 81 26
Utah................ 2 21 317 1 4 14 3
Nevada............. 5 269 3 2 -

PACIFIC.............. 86 2,219 11,556 7 207 261 615 8 248
Washington.......... 16 507 5,331 2 35 24 86 38
Oregon.............. 5 417 1,460 16 24 15 11
California.......... 65 1,260 4,523 5 144 203 445 8 182
Alaska............... 1 122 1 8 9 -
Hawaii............. 34 120 11 2 60 17

Puerto Rico.......... 6 315 1,867 17 9 20 1

*Delayed reports: Measles: N.H. 33, Mass. delete 32
Mumps: Me. 14
Rubella: Me. 1







226 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JUNE 15, 1968 AND JUNE 17, 1967 (24th WEEK) CONTINUED


STREPTOCOCCAL TYPHUS FEVER
SORE THROAT & TETANUS TULAREMIA TYPHOID TICK-BORNE RABIES IN
AREA SCARLET FEVER (Rky. Mt. Spotted) ANIMALS
Cum. Cum.. Cum. Cum. Cum.
1968 1968 1968 1968 1968 1968 1968 1968 1968 1968 1968
UNITED STATES... 6,294 3 58 4 81 11 127 8 62 45 1,725

NEW ENGLAND.......... 1,225 1 40 4 1 60
Maine*. ............ 11 50
New Hampshire...... 41 2
Vermont.............. 55 40 1 7
Massachusetts...... 159 2 1
Rhode Island....... 120 -
Connecticut........ 839 1 2

MIDDLE ATLANTIC...... 171 9 3 11 4 15
New York City...... 23 5 6
New York, Up-State. 130 4 3 2 1 11
New Jersey......... NN -
Pennsylvania....... 18 3 3 4

EAST NORTH CENTRAL... 549 1 8 2 6 1 21 2 5 155
Ohio............. .. 53 1 11 1 2 62
Indiana............ 111 1 1 56
Illinois........... 196 1 5 2 4 1 8 1 2 17
Michigan........... 64 2 1 1 9
Wisconsin.......... 125 1 11

WEST NORTH CENTRAL... 182 2 6 5 2 11 388
Minnesota.......... 20 2 109
Iowa............... 33 2 73
Missouri........... 34 2 4 3 2 68
North Dakota....... 46 4 65
South Dakota....... 6 I 1 1 34
Nebraska............ 34 1 1 19
Kansas............. 9 1 1 20

SOUTH ATLANTIC....... 904 11 5 4 35 6 39 5 195
Delaware .......... 1 -
Maryland............ 330 5 3 3
Dist. of Columbia*. 22 1 1 -
Virginia............ 215 2 1 1 7 2 17 82
West Virginia...... 158 1 2 26
North Carolina..... 8 2 2 2 1 12 7
South Carolina..... 9 1 I -
Georgia............ 6 1 1 9 2 4 2 25
Florida............. 155 4 1 2 11 1 2 1 52

EAST SOUTH CENTRAL... 818 1 8 6 2 15 2 8 7 429
Kentucky............ 28 i I 2 1 2 200
Tennessee.......... 674 2 4 2 10 2 5 4 210
Alabama................. 49 2 1 1 19
Mississippi........ 67 1 3 1 3 I -

WEST SOUTH CENTRAL.. 495 7 1 11 9 6 8 318
Arkansas........... 16 1 1 1 36
Louisiana......... 7 4 1 I 30
Oklahoma........... 36 2 2 4 2 99
Texas.............. 436 2 1 7 5 2 6 153

MOUNTAIN............. 1,111 1 4 1 9 1 1 38
Montana............. 19 -
Idaho .............. 51 -
Wyoming............. 5 1 1 1 2
Colorado............ 749 1 2 1 1
New Mexico......... 83 1 6 17
Arizona............ 91 1 18
Utah................ 113 2 -
Nevada.............-

PACIFIC.............. 839 1 12 3 18 7 127
Washington......... 128 -
Oregon.............. 58 1 2 3
California......... 531 1 11 3 16 7 124
Alaska............. 29 -
Hawaii............. 93 -

Puerto Rico.......... 10 5 15

*Delayed reports: SST: Me. 331, D.C. 94
Tetanus: Mich 1







Morbidity and Mortality Weekly Report


TABLE IV. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED JUNE 15, 1968

(By place of occurrence and week of filing certificate. Excludes fetal deaths)


All Causes Pneumonia Under All Causes Pneumonia Under
Area All 65 years and year Area All 65 years and 1 year
Ages and over Influenza All Age and over Influenza All
All Ages Causes All Ages Causes


NEW ENGLAND:
Boston, Mass.---------
Bridgeport, Conn.-----
Cambridge, Mass.------
Fall River, Mass.-----
Hartford, Conn.-------
Lowell, Mass.---------
Lynn, Mass.----------
New Bedford, Mass.----
New Haven, Conn.------
Providence, R. I.-----
Somerville, Mass.-----
Springfield, Mass.----
Waterbury, Conn.------
Worcester, Mass.------

MIDDLE ATLANTIC:
Albany, N. Y.---------
Allentown, Pa.--------
Buffalo, N. Y.--------
Camden, N. J.---------
Elizabeth, N. J.------
Erie, Pa.-------------
Jersey City, N. J.----
Newark, N. J.---------
New York City, N. Y.--
Paterson, N. J.-------
Philadelphia, Pa.-----
Pittsburgh, Pa.-------
Reading, Pa.----------
Rochester, N. Y.------
Schenectady, N. Y.----
Scranton, Pa.---------
Syracuse, N. Y.-------
Trenton, N. J.--------
Utica, N. Y.----------
Yonkers, N. Y.--------

EAST NORTH CENTRAL:
Akron, Ohio----------
Canton, Ohio----------
Chicago, Ill.---------
Cincinnati, Ohio------
Cleveland, Ohio-------
Columbus, Ohio--------
Dayton, Ohio----------
Detroit, Mich.--------
Evansville, Ind.------
Flint, Mich.----------
Fort Wayne, Ind.------
Gary, Ind.------------
Grand Rapids, Mich.---
Indianapolis, Ind.----
Madison, Wis.---------
Milwaukee, Wis.-------
Peoria, Ill.----------
Rockford, Ill.--------
South Bend, Ind.------
Toledo, Ohio----------
Youngstown, Ohio------

WEST NORTH CENTRAL:
Des Moines, Iowa-----
Duluth, Minn.---------
Kansas City, Kans.----
Kansas City, Mo.------
Lincoln, Nebr.--------
Minneapolis, Minn.----
Omaha, Nebr.----------
St. Louis, Mo.--------
St. Paul, Minn.-------
Wichita, Kans.--------


736
234
36
29
34
52
37
14
21
49
71
16
52
39
52

3,487
52
38
178
41
31
51
70
83
1,796
43
490
158
47
133
21
28
90
57
38
42

2,937
62
47
896
150
243
135
91
405
47
63
36
55
70
158
45
133
50
28
36
112
75

849
65
16
43
155
26
140
69
209
78
48


463
128
29
22
24
29
21
9
17
30
38
12
40
25
39

2,014
29
30
96
24
18
26
32
42
1,036
24
276
84*
35
82
16
21
54
30
31
28

1,744
43
26
533
94
129
70
55
256
28
38
22
25
45
73
20
84
24
18
23
78
60

504
42
14
17
84
11
95
45
117
48
31


42
17
2

3
5
2

1
4
5


1
2

144
3
2
10
1

1
3
4
66
3
29
3

12
1
i

4


2

126
1
3
44
6
8
8
1
12

2

6

11
6
8
6


2
2

54
4
1
5
11
2
8
3
14
5
1


SOUTH ATLANTIC:
Atlanta, Ga.-----------
Baltimore, Md.---------
Charlotte, N. C.--------
Jacksonville, Fla.-----
Miami, Fla.-------------
Norfolk, Va.------------
Richmond, Va.-----------
Savannah, Ga.----------
St. Petersburg, Fla.---
Tampa, Fla.-------------
Washington, D. C.------
Wilmington, Del.-------

EAST SOUTH CENTRAL:
Birmingham, Ala.-------
Chattanooga, Tenn.-----
Knoxville, Tenn.-------
Louisville, Ky.--------
Memphis, Tenn.----------
Mobile, Ala.-----------
Montgomery, Ala.-------
Nashville, Tenn.-------

WEST SOUTH CENTRAL:
Austin, Tex.-----------
Baton Rouge, La.-------
Corpus Christi, Tex.---
Dallas, Tex.-----------
El Paso, Tex.----------
Fort Worth, Tex.-------
Houston, Tex.----------
Little Rock, Ark.------
New Orleans, La.-------
Oklahoma City, Okla.---
San Antonio, Tex.------
Shreveport, La.--------
Tulsa, Okla.-----------

MOUNTAIN:
Albuquerque, N. Mex.---
Colorado Springs, Colo.
Denver, Colo.----------
Ogden, Utah------------
Phoenix, Ariz.---------
Pueblo, Colo.----------
Salt Lake City, Utah---
Tucson, Ariz.----------

PACIFIC:
Berkeley, Calif.-------
Fresno, Calif.---------
Glendale, Calif.-------
Honolulu, Hawaii------
Long Beach, Calif.-----
Los Angeles, Calif.----
Oakland, Calif.--------
Pasadena, Calif.-------
Portland, Oreg.--------
Sacramento, Calif.-----
San Diego, Calif.------
San Francisco, Calif.--
San Jose, Calif.-------
Seattle, Wash.---------
Spokane, Wash.---------
Tacoma, Wash.----------


1,223
128
288
43
86
100
54
82
26
75
52
251
38

588
81
57
48
129
115
50
34
74

1,211
39
37
27
172
49
80
238
64
186
78
136
35
70

435
49
17
104
14
112
20
64
55

1,748
28
38
37
52
107
644
89
29
107
57
99
183
35
149
57
37


582
58
133
17
40
60
25
42
10
60
25
93
19

305
51
30
26
73
53
24
15
33

620
24
20
13
88
27
43
99
37
88
44
80
18
39

245
29
10
56
10
62
17
30
31

1,039
21
19
26
23
56
400
52
23
71
28
51
94
26
79
43
27


56
2
8
1
I
1
1
8
6
4
8
7
9
1


1
9
2
12
2
1
4
3

26
5
2

3
2
1
1
2
3
2

1
4

16
5
1
5
2


1

2

2
2

2
5
10


1


2
1
1


Total 13,214 7,516 449 684


Cumulative Totals
including reported corrections for


previous weeks


All Causes, All Ages ------------------------ 316,072
All Causes, Age 65 and over------------------- 184,548
Pneumonia and Influenza, All Ages------------- 14,009
All Causes, Under 1 Year of Age--------------- 14,375


Week No.
24







Morbidity and Mortalily Weekly Report


INTERNATIONAL NOTES
INFLUENZA South America
In J.anu1ir ltl h, the(r as an outbreak of influenza
ill norl-hrn Chile, SuI bs5tqui ntI an outbreak of \2 influ-
enzia asciated with marked absenteeism occurred in San-
tiago.
In mid-March a severe epidemic of A2 influenza was
observed on Easter Island, national territory of Chile.
Nearly the entire population was affected, and therewere
some deaths in the older age group.
In late April, A2 influenza was first noticed in Men-
doza and San Juan. Argentina.2 These communities are in
western Argentina directly across the Andes from Santiago,
Chile. The epidemic in Argentina seems to he gradually
spreading from the west to the north and to the east, and
suspect outbreaks have recently been reported in Buenos
Aires and Pergamino. To date, nine influenza A2 viruses
have been isolated at the National Influenza Center of
of Cordoba. Argentina.
(Reported by Dr. E. Pearson, Head, Virus Department,
lastituto Bacteriologico de Chile. Santiago, Chile; Dr.
Violeta Kn e., Chief. Influenza Program, Un. ersidad Nacio-
nal de Cordoba. Institute de Virologia, Cordoba, Argentina,
Dr.. A. ilches, Director, Instituto Nacional de Micro-
biologia, Buenos Aires, Argentina; and WHO International
Influenza Center for the Americas, NCDC.)

References:
isI O Weekly I'l I ,1 I lr ord, 43:( 192 i, May 10, 1968.
2a-i O WIeekly I I I ., le rdi. 14 24 )30I, June 14, 1968.




ERRATA, Vol. 17, No. 23
Page 211
In the article, "Trichinosis Ohio," the list of per-
sons reporting the article is incomplete. The following list
is correct: "(Reported by Ralph A. Masterson, D.V.M.,
M.P.H., Chief, Epidemiology Section, Jack Russell, D.V.M.,
Chief, Veterinary Unit, Donald Baker, Investigator, and
Ohio Department of Health Laboratory, Ohio Department
of Health; Fred C. Kluth, M.D., Commissioner, Lake County
Health Dejpartment; and Joseph Koelliker, M.D., ','... ,.
Ohio.)"



Page 213
The page number in the reference in the article "Meth-
od of Recording Date of International Certificates of Vac-
cination," should be page 43 and not page 49.


Page 215
In the article "Measles Mortality United -i it.-.
1966," the title to Figure 5 is incorrect. The title should
be the following:
Figure 5
REPORTED MEASLES CASES (1912-1967) AND
DEATHS (1912-1966) PER 100,000 POPULATION,
UNITED STATES

The mortality data for 1967 are not yet available.


THE MORBIDITY AND MORTALITY WEEKLY REPORT. WITH A CIRCULA-
TION OF 17 000. IS .i. I --, : HE NATIONAL COMMUNICABLE
DISEASE CENTER, At. a. *-
DIRECTC N '~ Gri ':OMUNICABLE PE iEa e rENTER
PCIC ^ *:. : ER M.D.
CHIEF:. e i .' .-L"' i GO AM '.' L c r-Mu'P M.D*
ACTING ..*'EF i'. T. C ESEFTION IDA L. MERMAN M.S.
EDITOR MICHAEL B- GREGG, M.D

IN ADDITION TO THE ETI*' '"E.. PO:-E LWE5S FOR REPORTING
MORBIDITY AND MORTALITY, THE T.li AL *'CMMUN": 66LE ISE ASE
CENTER WELCOMES ACCOUNTS.OF IN T i w i ; r- OUT RE a 5 R rC5E
INVESTIGATIONS WHICH .-, OF CUREr.;- l ,'-'`c-i T TO HEALTHH
OFFICIALS AND WHICH. *E C.I~ r ,T L AT riT Tr, Tt roa OL
OF COMMUNICABLE :' E ,_*H COU MMU.jfl d T'*.:,. JLD BE
ADDRESSED TO:
NATIONAL COMMUNICABLE DISEASE CENTER
ATLANTA, GEORGIA 30333
ATTN: THE EDITOR.
MORBIDITY AND MORTALITY WEEKLY REPORT

NOTE: THE "DATA IN THIS REPORT ARE PROVISIONAL AND ARE
BASE -N *EEL I ELE;i.:-MS TO THE NCDC BY THE INDIVIDUAL
STA'E -LT DI C IkIME i. THE REPORTING *EEI CONCLUDES
ON A4 .-MPr.._c. C' a ON A NATIONAL BASIS ARE RELEASED
ON THE SUCCEEDING FRIDAY.




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